Sharing experience on taking the CICE

One of our trainees, who was successful In the CICE, has kindly shared the study materials she used.

Thanks and a big congratulations to her.

No exam is easy to pass. It needs effort and preparation. The key to passing the exam is question practice based on my previous exam experiences in my life. As the saying goes, practice makes perfect; the more you practice the exam format of either best of five questions or PACES hundred times, the higher the chance you will have PASS. However, I find the CICE quite challenging. There is no question banks to practise, no specific study materials to read, and no courses to guide how to pass the exam like MRCP or other speciality exit exams. I have struggled a lot during exam preparation due to the exam challenge and the unexpected situation in my mother country. But that is how I have prepared for the CICE.

Before I share my exam experience, I explain my background slightly because not all the readers are UK based exam candidates. I believe everyone will have different ways of exam preparation depending on their background experiences. I am one of the speciality trainees in the two years combined infection training program of the UK, including medical microbiology, infectious disease, and virology rotation. I did the exam after 19 months of training. I have been attending the MSc Infectious disease by distance learning from the LSHTM for 1-2 years before enrolling in the training. However, I started reading, focusing on the exam four months before the exam dates, and intensively prepared for about three weeks.

I prepared the reading list based on the combined infection training curriculum, which includes ten main topics.

1. The basic biology of bacteria, viruses, fungi, and parasites: host-pathogen relationships

2. Microbiology/virology laboratory practice

3. Health and safety

4. Principles of public health about communicable disease

5. Infection prevention and control

6. Important clinical syndromes

7. Understanding the use of antimicrobial agents

8. Vaccination

9. The management of HIV infection

10. Travel and geographical health

The curriculum details can be found in this link – https://www.jrcptb.org.uk/sites/default/files/2015%20Iinfectious%20Diseases%20Curriculum%20with%20HIT.pdf

I have read MIMS Medical Microbiology. I think any medical microbiology textbook can cover basic science.

Basic medical statistics like specificity, sensitivity, NNT, power of the test, etc., must know as well. I read the Oxford Handbook of Medical Statistics.

I am not good at this topic, to be frank, as I have too little experience in the laboratory.

UK SMI (https://www.gov.uk/government/collections/standards-for-microbiology-investigations-smi),

PHE guidelines (https://www.gov.uk/government/organisations/public-health-england), and the local laboratory SOP are helpful to me.

https://www.hse.gov.uk/ - I found to be helpful, particularly about ACDP (https://www.hse.gov.uk/pubns/misc208.pdf),

management and operation of microbiological containment laboratories (https://www.hse.gov.uk/biosafety/management-containment-labs.pdf),

Again, the Public Health England website is a must for reading material.

Manual of Infection Prevention and Control by Nizam Damani is also a good resource for primary IPC.

Oxford Handbook of Infectious Diseases and Microbiology covers most of the essential clinical syndromes. In the exam, I have also applied the clinical experience that I have gained throughout my life.

IDSA guidelines like Management of Candidiasis (https://www.idsociety.org/practice-guideline/candidiasis/)

https://www.rcog.org.uk/en/guidelines-research-services/guidelines/ is a good source for infections in pregnancy and neonate.

I think the reading materials are extensive for this category.

Mechanism of actions, antimicrobial coverage spectrum, antimicrobial resistance including the primary genetic mechanism and detection methods like CPE, MRSA, ESBL etc.

Oxford Handbook of Infectious Diseases and Microbiology, PHE, UK SMI

Greenbook immunisation is the primary study material.

(https://www.gov.uk/government/collections/immunisation-against-infectious-disease-the-green-book)

BHIVA guidelines ( https://www.bhiva.org/guidelines) and BASHH guidelines (https://bashh.org/guidelines)

https://www.cdc.gov/ is a good reference for travel and geographical health.

The following websites are beneficial for me during exam preparation, particularly https://microregistrar.com/. All are free, and practising questions give some ideas how the exam questions would be like and what to focus on in the intensive preparation period.

You can find a list of helpful books and websites:

‘Tutorial Topics in Infection for the Combined Infection Training Programme’ and ‘Infectious Diseases, Microbiology and Virology: A Q&A Approach for Specialist Medical Trainees’ are only two books published so far for question practice. I do not think these should replace textbooks and reading materials.

I made my notes throughout my reading to know which one I need to carry in my head to the exam, which one I must memorise again, which one I still need to digest and understand the topic, etc., during the intensive study period.

I feel that CICE is testing the breadth of the knowledge rather than the depth. Although the reading lists are incredibly long, it is essential to digest the ordinary things in detail from A to Z that we see daily in our clinical practice. The exam is testing whether the candidates have the right amount of knowledge required to practice safely in our daily life. Rare diseases and new antibiotics might pop up in the exam. However, I would say common infections, frequently used antibiotics, standard laboratory methods should always be prioritised in exam preparation, e.g., HIV, HBV, HCV, STIs, Syphilis, Staphylococcus, Penicillin, Cephalosporins, Carbapenems etc.

That is how I have prepared and passed the CICE on the first attempt.

I hope that is helpful to all readers who will sit at the CICE in the future.

Good luck with your exam!